Clayton A. Chan, D.D.S. Founder/Director

About Dr. Chan

Dr. Clayton Chan is a dental educator, trainer and consultant to dentists who span the globe from private practice to leading dental organizations. All attest to Dr. Chan's unique impact in the field of private practice, personal and organizational transformation and development.

Dr. Chan has shared platforms with leading authorities in the areas of occlusion, temporomandibular joint dysfunction, orthodontic/orthopedics and comprehensive restorative and continues to be a leader in advocating the use of objective measuring technologies to bring accountability to the clinical dental practice.

Occlusion Connections™ is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing dental education programs of this program provider are accepted by AGD for Fellowship/Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 9/1/2016 to 8/31/2020. Provider ID# 349336.

Welcome to OC

A new understanding is required of today’s dentist to grasp underlying factors that relates clinical dentistry to both the gnathic and neuromuscular principles. This journey is a blended process that brings an in depth understanding with clinical experience. Together with excellence based on honesty, respect, discipline and courage these organic concepts will come together in both skilled clinical application and bio-physiologic science. This is GNM.

Finding a Qualified GNM Dentist

Disclosure:
It is the responsibility of each patient to ask the right questions in order to determine whether a dentist is qualified to meet your particular dental needs. Dentist have varying degrees of knowledge, experience, training and skills. Occlusion Connections™ is not responsible for the diagnostic and clinical decision making that each dentist makes when treating their patients.

The dentist listed on this map have taken varying levels of OC courses. It is your responsibility to determine if each one is qualified to treat and help meet your particular needs.

The National Institute of Dental and Craniofacial Research (NIDCR) ignores that TMD may have not only a muscular component to this disease/dysfunction, but that it also may have an occlusal component as well is an over-site which only exemplifies its intent to ignore the bio-physiologic factors of the stomatognathic system and posture of the upper quarter of the bodies systems.

It suggests that medicine is the solution to TMD problems.

It suggests that TMD often resolves itself and is self-healing.

It emphasizes that TMD is a self-limiting disease and occlusal (bite) changes are to be avoided.

It does not acknowledge that TMD is a major component in the scope of dental practice nor does it recognize that the dentist has a major role in dealing with muscles, joints and teeth as it pertains to temporomandibular joint disorder and all the associated signs and symptoms that relate to the trigeminal system.

Taking a “wait and see” approach to disease based on unfounded, conflicting opinions that TMD is both innocuous and unaffected by preventative therapy lacks responsibility to the public. A support for pain medications that can lead to dependency and drug abuse in dealing with chronic pain rather than a philosophy of support toward prevention is irresponsible.

To improperly suggest that occlusion is not even remotely related to TMD when it has been well demonstrated that loss of posterior occlusal support and parafunction have a role, even if an indirect one, is fatuous. If the latter is an unfair criticism, why then would one support the use of flat splints presumably to avoid parafunction?

To convey that jaw joint X-rays (transcranial/tomographic radiographs) are not generally useful in diagnosing TMJ disorders is unconscionable and confused as to the understanding and appreciation of the TM joint. Not having an ability to distinguish normal from abnormal, pathologic from physiologic affords the doctor no possible way to diagnose nor render appropriate therapy. It is not customarily used as a first radiographic procedure, but rather for conditions of long-standing pain and limitation of jaw movement that have not been responsive to conservative treatment. MRI may be indicated in cases of direct trauma to the joints as an early diagnostic modality.

No mention of the American Dental Association’s granted Seal of Acceptance to three computerized measurement devices that aid in the management of TMD are mentioned in this philosophy.

BACKGROUND: Psychosocial factors have a role in the onset of chronic orofacial pain. However, current management involves invasive therapies like occlusal adjustments and splints which lack an evidence base.

OBJECTIVES: To determine the efficacy of non-pharmacologic psychosocial interventions for chronic orofacial pain.

SEARCH METHODS: The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 25 October 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE via OVID (1950 to 25 October 2010), EMBASE via OVID (1980 to 25 October 2010) and PsycINFO via OVID (1950 to 25 October 2010). There were no restrictions regarding language or date of publication.

SELECTION CRITERIA: Randomised controlled trials which included non-pharmacological psychosocial interventions for adults with chronic orofacial pain compared with any other form of treatment (e.g. usual care like intraoral splints, pharmacological treatment and/or physiotherapy).

DATA COLLECTION AND ANALYSIS: Data were independently extracted in duplicate. Trial authors were contacted for details of randomisation and loss to follow-up, and also to provide means and standard deviations for outcome measures where these were not available. Risk of bias was assessed and disagreements between review authors were discussed and another review author involved where necessary.

MAIN RESULTS: Seventeen trials were eligible for inclusion into the review. Psychosocial interventions improved long-term pain intensity (standardised mean difference (SMD) -0.34, 95% confidence interval (CI) -0.50 to -0.18) and depression (SMD -0.35, 95% CI -0.54 to -0.16). However, the risk of bias was high for almost all studies. A subgroup analysis revealed that cognitive behavioural therapy (CBT) either alone or in combination with biofeedback improved long-term pain intensity, activity interference and depression. However the studies pooled had high risk of bias and were few in number. The pooled trials were all related to temporomandibular disorder (TMD).

AUTHORS’ CONCLUSIONS: There is weak evidence to support the use of psychosocial interventions for chronic orofacial pain. Although significant effects were observed for outcome measures where pooling was possible, the studies were few in number and had high risk of bias. However, given the non-invasive nature of such interventions they should be used in preference to other invasive and irreversible treatments which also have limited or no efficacy. Further high quality trials are needed to explore the effects of psychosocial interventions on chronic orofacial pain.

DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened studies, extracted data and assessed risk of bias. Dichotomous outcomes, were expressed as risk ratios with 95% confidence intervals, continuous outcomes as mean differences with 95% confidence intervals. Heterogeneity was assessed using the Cochrane test for heterogeneity and the I2 test. Meta-analyses were conducted using the random-effect or the fixed-effect models.